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Women can now order the contraceptive pill online and have it delivered to their door within 24 hours, with a new service design system being trialled in London.

Online sexual health service SH:24 has launched a free online service, which aims to streamline the process of receiving contraception and save time for female patients and doctors.

Users access the SH:24 site, choose either the combined pill or progestogen-only pill, then fill out an online health assessment. The website needs to be accessed either through a mobile or desktop browser, as there is no iOS or Android app. This decision was based on user-testing, which informed the team that the majority of users would not want a sexual health app on their phone.

The forms are then assessed by bots using “intelligent logic”, says SH:24, and if there are no medical risks, sent to a General Medical Council (GMC)-approved doctor.

They will review and approve it, then sign a prescription, which will be dispensed by SH:24’s partner pharmacy and delivered to the patient within one working day. They do not need to be home to receive it. Along with the medication, there are written instructions on how to take it.

“Short but robust” service that “mimics” clinic visit

If there are risk factors, users will receive a call from a doctor or nurse who will talk to them and decide whether the pill is safe to prescribe or not. If not, they will advise users to go to a clinic to discuss other forms of contraception.

The new system has been co-designed by service designers, clinicians and around 70 women who currently use contraception clinics. The project was headed up by SH:24 director Dr Paula Baraitser with service development led by product designer Chris Howroyd, former head of health at the Design Council.

On the safety of the system, Howroyd says the online risk assessment “mimics” that of a clinic and is “short but robust”, including all the questions that a doctor would ask in a face-to-face assessment.

He adds that the service hopes to “instil trust” that doctors “are not going to prescribe without reviewing or validating responses”. The SH:24 website is officially affiliated with the NHS, carrying the logo on its website.

Aims to save local NHS £46,000

The system went through a minimum of 20 iterations before the system was finalised, says Howroyd.

It is currently being trialled in London boroughs Lambeth and Southwark, working with the National Health Service (NHS) in those areas.

The online service aims to be “more convenient and cost-effective”, Howroyd says, and aims to save the local NHS £46,000, which would have been spent on appointments. It will also free up time for GPs and nurses, he adds, and aims to be more convenient and comfortable for patients than a real life appointment.

“The biggest barrier is walking through a door”

“People are empowered to speak about sexual health in an anonymous situation, in a way they may not be face-to-face,” says Dr Baraitser, a clinician who led on the project.

She adds: “Countless studies of users show that the biggest barrier is walking through the clinic door into a waiting room full of people. We’re trying to create a more open and accessible conversation around contraception in general.”

It allows users to order a self-testing kit, which is then delivered to them, completed, and the patient then posts it back without the need to visit a clinic, unless they need treatment or medication.

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I think this is a good service! Love the explanation and how you go about meeting needs. Some of the moments, however, feel a bit idealistic. For example, the 2nd pane in both journeys show a patient making the time to sit and study what’s needed and then go through the steps of acquiring contraception. I think a person’s decision may be a bit more impulsive than this – I seldom find that users have perfect windows to deeply investigate things online and know IMMEDIATELY where to go to get help. Would have loved a deeper exploration into discoverability of the service and this playing out in a mobile context.